Technology Appraisal Guidance No. 208
Source: National Institute for Health and Care Excellence
1.1 Trastuzumab, in combination with cisplatin and capecitabine or 5-fluorouracil, is recommended as an option for the treatment of people with human epidermal growth factor receptor 2 (HER2)-positive metastatic adenocarcinoma of the stomach or gastro-oesophageal junction who:
- have not received prior treatment for their metastatic disease and
- have tumours expressing high levels of HER2 as defined by a positive immunohistochemistry score of 3 (IHC3 positive).
1.2 People who are currently receiving treatment with trastuzumab for HER2-positive metastatic gastric cancer who do not meet the criteria in 1.1 should have the option to continue treatment until they and their clinicians consider it appropriate to stop.
The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at
An abridged version of this guidance (a 'quick reference guide') is also available. Printed copies of the quick reference guide can be obtained by ing 0845 003 7783 or emailing and quoting reference number N2363. It is also available on the Internet at
This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
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Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email:
Trastuzumab for the Treatment of HER2-Positive Metastatic Gastric Cancer.
Issue Date: November 2010
Review Date: August 2013